Khan, Mohsin Raza, Nazir, Muhammad Arsalan ORCID: https://orcid.org/0000-0001-5416-9010 and Afzal, Sabeen (2024) A need for a comprehensive health financing strategy in Pakistan: an analysis of key health financing issues. Journal of Health Organization and Management. ISSN 1477-7266 (doi:10.1108/JHOM-05-2024-0192)

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Abstract

Purpose
This study aims to analyze the challenges in financing the healthcare system of Pakistan and develop a comprehensive health financing strategy aimed at achieving universal health coverage (UHC).
Design/methodology/approach
The paper utilizes World Health Organization (WHO) framework on health financing to build the argument. It uses qualitative research design involving focus group discussions and in-depth interviews with key stakeholders, including Federal Board of Revenue, Ministry of Finance, Planning Commission, development partners, academia and health ministries at federal and provincial levels, as well as social health insurance entities.
Findings
The research findings highlight several critical issues within Pakistan’s healthcare system: Firstly, health spending is inadequate to provide financial protection to 24 million people. Secondly, the available health funding is allocated in clusters and caters primarily to specific groups, which exacerbates inequities in healthcare provision. Thirdly, the existence of multiple purchasing agents who operate concurrently to buy health services results in duplication and wastage of resources. Fourthly, the public financial management system, intended to support the swift distribution of public funds to health facilities, is not aligned with the requirements of the health system. Lastly, the devolved health setup has led to governance issues in managing the health sector.
Originality/value
This study fills a significant gap in the literature on health financing within Pakistan and proposes a unique empirical approach using WHO’s framework in a decentralized healthcare context. It also provides actionable recommendations for policymakers to develop strategies that improve the effectiveness of public financial management and health service delivery.

Item Type:	Article
Uncontrolled Keywords:	public health management, financial management, health financing strategy, fiscal space for health, universal health coverage, governance and reform
Subjects:	H Social Sciences > H Social Sciences (General) H Social Sciences > HJ Public Finance R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Faculty / School / Research Centre / Research Group:	Greenwich Business School Greenwich Business School > Executive Business Centre
Last Modified:	19 Feb 2025 20:15
URI:	http://gala.gre.ac.uk/id/eprint/49737

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